The inspection took place on 10 June 2016 and was unannounced. The service provides personal care for seven people, six people live together in one accommodation and require support with their learning disability or mental health needs. Another person lives on their own and is supported by the service. On the day of our inspection seven people were using the service. The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were protected from the risk of abuse as staff had attended training to ensure they had a good understanding of their roles and responsibilities, if they suspected abuse was happening. Evacuation plans of how to leave the accommodation in the event of an emergency such as a fire were in place.
People were supported by a sufficient number of suitably trained and experienced staff and 24 on call support was available for the staff to call upon. The management team were looking to increase their presence at the service outside of core hours. Some people considered that additional 1:1 designated time would be of benefit to people on occasions given their condition on the day or to prepare for an event.
The provider had ensured appropriate recruitment checks were carried out on staff before they started work at the service. Staff had been recruited safely and had the skills and knowledge to provide care and support in ways that people preferred.
The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. People at the service were subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
Positive and caring relationships had developed between people and staff. The staff on duty knew people well and throughout the day we observed positive interactions between people using the service and staff. People were supported to make day to day decisions and were treated with dignity and respect at all times. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and enabled to be as independent as possible in all aspects of their lives. We saw that people enjoyed days out, holidays to a caravan park, and attending social clubs that were people’s individual choice.
Staff knew people well and were skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People, where able, were involved in the planning and reviewing of their care and support. Daily notes were written in an informative style and were up to date.
People’s health needs were managed appropriately with input from relevant health care professionals. We saw that people attended appointments with their GP and also hospital consultants. People were supported to maintain a nutritionally balanced diet and sufficient fluid intake to maintain good health. Staff ensured that people’s health needs were effectively monitored.
People were supported to maintain relationships with friends and family so that they were not socially isolated. There was an open culture approach by the management and staff were supported to provide care that was centred on the individual. The care plans were written in a person-centred style and there was clear involvement of the person themselves and their families. The team leader on duty was approachable to support staff and enabled people who used the service to express their views.
People and their relatives were supported to report any concerns or complaints and they told us they felt they would be taken seriously. People who used the service, or their representatives, were encouraged to be involved in decisions about the service. The care plans were reviewed yearly and as required in response to changes in a person’s condition.. The provider had systems in place to check the quality of the service and took the views and concerns of people and their relatives into account to make improvements to the service.